If You’re Vaccinated, You Can Live Your Life Again. It Really Is That Simple.

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Photo credit: Justin Sullivan - Getty Images
Photo credit: Justin Sullivan - Getty Images


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By late April, at a time when more than 95 million people in the United States had been vaccinated against COVID-19, the Centers for Disease Control said it had received reports of 9,245 "breakthrough infections." These are cases where a fully vaccinated person still managed to contract the disease. This was probably something of an undercount, the CDC clarified, because it "relies on voluntary reporting from state health departments which may not be complete. Also, not all real-world breakthrough cases will be identified because of lack of testing." But even if the real number of breakthroughs was 10 times the number we know of—90,000 vs. 9,000—it would still represent a minuscule percentage of those vaccinated. This echoes what the CDC reported in early April: "a growing body of evidence suggests that COVID-19 vaccines may also reduce asymptomatic infection, and potentially transmission." Because the vaccines seem to largely prevent people from getting this thing at all, most won't pass it on to others, either.

There was also some evidence of this from the various vaccine manufacturers' clinical trials, even if monitoring this aspect took a backseat to examining the prevention of severe disease. Pfizer-BioNTech, Moderna, and Johnson & Johnson all reported big drops in asymptomatic infections among those vaccinated: J&J estimated a 74 percent reduction, while Pfizer came in at 85 to 89 percent. Another study found that people who'd had just one dose of the Pfizer vax had "viral loads" up to 20 times lower than unvaccinated people who contracted the disease, suggesting that even if you do pick up the virus, you're not carrying nearly as much of it—and thus are less likely to pass it to other people. This is the subtext of the calls from health officials for you to get vaccinated "to protect yourself and others."

All of this is in addition to the baseline finding that the vaccines prevent almost all hospitalization and death (of those 95 million vaccinated in the CDC report above, there were 825 reported hospitalizations, and a quarter of those were asymptomatic or not COVID-related), and that they continue to be effective against known "variants of concern"—like the London or South African or Brazilian strains—they've studied. (BioNTech said Monday that it currently sees "no evidence" that it will need to adapt the vax it developed with Pfizer to combat any new variants, though it is making preparations in that regard. Moderna seems to be farther along on that front.) Barring the development of some Super Strain that evades these protections, it seems like the news is...quite good indeed. If you get vaccinated, it is vanishingly unlikely that you will get severe symptoms, have to be hospitalized, or die. In fact, it is looking more and more unlikely that you will contract the disease at all, or in enough of a viral concentration that you are at major risk of passing it to other people. One principle for life in a free society is that if you're not infringing on the rights of other people, you're usually good to do what you're doing.

Which made the TV testimony of former FDA chief and current Pfizer board member Scott Gottlieb seem pretty reasonable on Monday morning.

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This was in line with what he had to say on Thursday of last week:

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We are at the point where we need to convince the unenthused to get vaccinated, and while there are many tools in the toolkit—apparently, free beer stays undefeated—a big one surely must be a big neon sign that says, "YOU GET YOUR LIFE BACK." If at-risk people will be protected from hospitalization and death, and if, as increasingly seems to be the case, very few among the vaccinated will even be contracting or spreading the disease, there is a building scientific basis for the idea that masks for vaccinated people are unnecessary. But it's also crucial in demonstrating to people the real value of vaccines: they will get us back to the things we want to do. It's understandable that the CDC approaches this with caution, and maybe there's a basis for masks in grocery stores and shops, and on public transportation, for a little while longer. Certainly, we can hope that masks on buses and planes and the subway become a durable social norm during flu season.

In fact, as more and more people get vaccinated, COVID is becoming more like the flu—or even the common cold. It was wrong for people to make the comparison early on in the pandemic, but it's becoming more and more apt. Yet we're still getting headlines from the Paper of Record about how herd immunity is now out of reach for our society, complete with warnings that the disease will be "an ever-present threat." (Monday saw the second such headline in the space of the week, though the first article clarified that it will be a "manageable threat.") Herd immunity is not necessary to get back to our lives. We just need to stop people dying from this disease, which the vaccines do. This novel coronavirus may never be eradicated completely, and that's fine. Some forms of the common cold are coronaviruses that once may have wreaked havoc on our species. We adapt. We've used the incredible ingenuity of our species to change our relationship to this pathogen in record time. Human beings have engineered a scientific miracle, one we should celebrate by adapting the rules of our pandemic response as the evidence indicates.

The longer we wait to adapt our standards, though, the more the credibility of public-health experts (and the press) takes on damage, just as Gottlieb suggested. I've seen it anecdotally in talking to people who generally defer to public-health recommendations, but who view the framing of these discussions as increasingly absurd. On the media side, the thirst among some news consumers for so-called "Doombait," and the willingness among outlets to supply it, does not seem to have waned as fast as the numbers of cases, hospitalizations, and deaths. Dr. Anthony Fauci voiced some support for Gottlieb's position on Sunday, though he stressed he feels national case levels are still too high. (That gets at Gottlieb's other point, about adjusting rules by jurisdiction depending on local prevalence.) But then his interviewer, George Stephanopoulos, started asking Fauci about what "next Mother's Day" is going to look like. George, my man. We're headed towards a normal summer. We're all shook up from this period in our lives, but we have to ditch some of the calcified assumptions we've developed in that time. Reuters creasted an entire interactive PAC-MAN-style graphic around the return-to-office, in which the goal seems to be to never interact with any of your coworkers under any circumstances. Folks, we're going to be vaxxed up. You can chat with your friends at work. We need to dial back the absolutism, or many people will absolutely stop paying attention.

Photo credit: STUART FRANKLIN - Getty Images
Photo credit: STUART FRANKLIN - Getty Images

We are getting towards the stage where life is, once again, a choose-your-own-adventure: if you are still wary, you can continue limiting your contacts. (Many people have not had that luxury at any point in this era.) But if you are ready to get back to life, you can do so in good standing, confident that you will not get very sick and die, and increasingly confident that you cannot pass the pathogen on to others. The potential for new variants to develop and get around the vaccines is frightening, especially as COVID ravages other countries, like India, and the United States is only beginning to get doses to the rest of the world. Where COVID is spreading, it's mutating. The Biden administration has signaled its support for loosening patent protections on the vaccines on an emergency basis so other countries can mass-manufacture their own doses, though it's unclear what the timeframe is on that.

But we are getting to a place in this country where we can start to do the things that make life worth living again. We must honor those we lost, and acknowledge that we lost more than we should have, and learn from that. But it's hard to believe that anyone who died from this vicious disease would want we, the living, to delay going back to some of the best things in life longer than is necessary. We can honor them with monuments and remembrances, but we can also honor them by enjoying ourselves. Raise a glass—your free vaccination beer, maybe—with a promise to devote yourself to a life well-lived. As it stands, I intend to go to some concerts this summer. Maybe even a club. That doesn't mean you have to do the same. If being vaccinated means you are not putting others at risk, and this lack of spread means cases and hospitalizations and deaths continue to drop, it's time to choose your own path through the world, just like you did a year and a half ago.

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